Antibiotic Resistance Rates of Klebsiella pneumoniae Strains Isolated from Urine Culture: A Five-Year Analysis

Abstract

Objective: The aim is to determine the frequently encountered microorganisms in urinary tract infections (UTIs) in children in our region, their antibiotic sensitivity and resistance patterns, and based on our findings, to identify empirical antibiotic treatment options for our region. Material and Methods: Urine culture results and antibiotic susceptibility profiles of pediatric patients who were diagnosed and treated for urinary tract infections at Ankara Keçiören Training and Research Hospital Pediatric Clinic between the years 2015 and 2020 were retrospectively evaluated. Statistical analysis using the SPSS program was conducted to determine whether there was a significant relationship between resistance changes and the patient’s complaints, symptoms, and demographic characteristics. Results: A total of 416 cases (female/male= 246/170) were included in the study. Among the cases, 295 (70.9%) had cystitis, 107 (25.7%) had acute pyelonephritis, and 14 (0.2%) were diagnosed with urosepsis. Ad-ditionally, 31 cases (7.4%) had recurrent urinary tract infections. Among the patients, 43 (10.3%) showed no resistance to any antibiotics in urine culture antibiotic sensitivity tests, while 139 (33.4%) cases had resistance to one antibiotic, 169 (40.6%) cases had resistance to 2-5 antibiotics, and 65 (15.6%) cases had resistance to >5 antibiotics. In extended-spectrum beta-lactamase (ESBL) resistance, a statistically significant difference was observed especially in the year 2019 (p< 0.001), and this difference was prominent in patients with urogenital anomalies and/or vesicoureteral reflux. Conclusion: Klebsiella pneumoniae has developed statistically significant resistance over the years, particularly against cephalosporins and many other types of antibiotics. The presence of urogenital anomalies like VUR is a significant risk factor for the development of resistance.